Perimenopause is the Cause

Written by: Dr. Fiona Lovely, Chiropractor, Functional Medicine Practitioner and Menopause Doula at AST


Many times, I am asked by women feeling the impending menopause experience, “What can I do now to help myself” for those years?  It’s a great question and there is much you can do.  

First, let’s talk terms.  Menopause is the time when you have been 12 months without a menstrual period.  The 10-ish years before that are what is now referred to as perimenopause.  As the typical age for menopause is 52, it is likely you have entered perimenopause by the time you are in your early 40s.  For some women, it’s at 35. Let the math be fluid on this, as every woman is different.  

How do you know you are in perimenopause?  The early signs are the change in quality and length of sleep and a change in moods.  You may not be easily able to elevate your mood to match the environment.  Anxiety can show up or worsen.  Same with depression.   Perimenopause is a neuroendocrine transition which means the brain is signalling the hormones to create a new normal.  This transition can be long, so its helpful to know you can expect change. 

For many women in their late thirties and early forties, you may be in your child-birthing years and brush these early symptoms off as a lack of sleep, or the baby-blues or stress.  These things may in fact be caused by the hormonal shifts of perimenopause. Your levels of testosterone and progesterone do a slow decline towards menopause.  Estrogen levels can be quite high or low and can swing wildly.  You can feel moody, sleepy, less strong, less sharp mentally and your cycle can get shorter, meaning you can bleed every 25 or 26 days instead of 28-30 days.  

In the forties, women can experience the more classic signs of menopause like hot flashes, dryness, lack of libido, deepening insomnia, feelings of low self worth, low confidence, anxiety and/depression.  This is a delicate time for a woman as she can easily be misdiagnosed with a mental health disorder instead of being treated for perimenopause.   You may not have even had a hot flash or a skipped period at this point.  

On a list of the top ten most common symptoms of perimenopause, hot flashes are number 10.  Many women never have a hot flash, so please don’t wait to assume you are in perimenopause only when your periods change or you experience a hot flash! 

Reducing stress, recognizing your symptoms are a result of changing hormone levels, getting enough rest, nutritious food, outside light and daily enjoyable movement are important for preparing yourself for a gentle perimenopause.  Eating enough daily protein and strength training for maintaining muscle health is important too. 

In short, if you are a woman between 35-55 years of age and something recently has changed with your health, it’s likely related to perimenopause!   It begins long before you miss a period.  Look for great practitioners who can coach you through this transition.  Perimenopause can be a chaotic time where the help is thin on the ground. 

Have you considered speaking with a Menopause Doula?  We can help guide the way forward to better sleep, a peaceful mind and a calm and cool physical self.  

Contact AST Willow Park to schedule an appointment with Dr. Fiona Lovely today.

Not ready to make an appointment but want to learn more, head to Not Your Mothers Menopause Podcast. Hosted by Dr. Fiona Lovely.

Musculoskeletal Syndrome of Menopause

Written by: Dr Fiona Lovely, DC

Many women are arriving in clinic with complaints of stiffness, sore, achey muscles and joints without experiencing this previously.  These women tend to be 40+ in age and lack an injury to cause the discomfort.  It’s important to consider how your hormones at midlife may be affecting your body.  

Menopause is not only characterized by hormonal changes and reproductive system adjustments but also by various musculoskeletal symptoms that can significantly impact a woman's quality of life. This is called the Musculoskeletal Syndrome of Menopause (MSM).  This encompasses a range of symptoms affecting the bones, joints, and muscles, which can be attributed to hormonal fluctuations.  

One of the most common musculoskeletal symptoms experienced during menopause is osteopenia and osteoporosis, a condition characterized by decreased bone density and increased risk of fractures. Estrogen plays a crucial role in maintaining bone health by inhibiting bone resorption and promoting bone formation. However, during menopause, declining estrogen levels lead to accelerated bone loss, especially in weight-bearing bones like the spine, hips, and wrists.

Menopausal women frequently report joint pain and stiffness, commonly attributed to osteoarthritis. Estrogen has anti-inflammatory properties that help protect joint cartilage and maintain joint function. As estrogen levels decline, inflammation increases, contributing to the development and progression of osteoarthritis, particularly in weight-bearing joints like the knees and hips.

I like to say that estrogen is a lubricator of all tissues, this is especially true with joints.  For example: I see many women in their 40’s and 50’s with new shoulder complaints which can be attributed to the estrogen decline.  The shoulder is the most freely moveable joint in the body and when it isn’t working well, you notice!

Muscle weakness and decreased muscle mass, known as sarcopenia, are also prevalent musculoskeletal symptoms of menopause. Estrogen has anabolic effects on skeletal muscle, promoting muscle growth and strength. Declining estrogen levels during menopause can accelerate muscle loss and impair muscle function, leading to decreased mobility, flexibility and function.

Menopause-associated hormonal changes can trigger new onset musculoskeletal symptoms, including tendonitis and bursitis.

Understanding the musculoskeletal implications of menopause is crucial for implementing preventive measures, such as regular weight-bearing exercise, maintaining flexibility with daily stretching, keeping your spine healthy with regular chiropractic treatments, adequate magnesium glycinate and vitamin D intake, and hormonal therapy when appropriate, to mitigate the impact of these symptoms and promote musculoskeletal health and well-being in menopausal women.

Dr. Fiona Lovely is a Chiropractor at AST Willow Park and can help you with your perimenopause and menopause-related concerns. In addition to her practice at Active Sports Therapy Dr. Fiona Lovely is the host of the wildly popular podcast "Not Your Mother's Menopause" which can be found on all of your favourite podcast platforms.

Menopause from a Traditional Chinese Medicine Doctors Prospective.

Written By: Dr. Wanda Duong DTCM, R.Ac., BSc. and Dr. Vikki Maguire DTCM.

The years leading up to menopause can bring tremendous changes to the female body. Although a natural biological process, menopause is not experienced the same by all individuals. Symptoms associated with menopause often create secondary symptoms that affect sleep patterns, energy levels, and overall physical and emotional well-being.

Menopause is the result of a dynamic decline in the function of the ovaries to produce eggs and associated hormones that regulate menstruation. This normal transition in menstruation often occurs between the ages of 45-55 years, though it can begin earlier in some females.  Symptoms associated with menopause are multivariate and can include difficulty concentrating, muscle and joint pain, changes in skin texture and appearance, urinary disruptions, mood changes, decrease libido, fatigue, and hot flashes and night sweating as the most prominent symptoms that most individuals experience.   

Like the western medicine approach to addressing menopause, traditional Chinese medicine (TCM) also aims to regulate the body’s internal thermostat to control and reduce symptoms such as hot flashes and night sweating, as well as support and stabilize a healthy change in hormone levels. However, TCM takes a more natural and holistic approach, that often has little to no negative side effects, and individuals often see improvements in many secondary areas such as quality of sleep, reduced aches and pains, improved skin and hair health, stabilized mood changes, and an increase in libido and energy.

Traditional Chinese medicine (TCM) uses a combination of modalities to create a personalized treatment plan based on the individual’s needs and underlying issues that are found through TCM diagnosis. A combination of acupuncture, herbal formulas, and dietary/lifestyle recommendations is often utilized.

TCM acupuncture utilizes specific point combinations to encourage the body to trigger the release of specific chemicals and hormones. This is done by stimulating the nervous system to then communicate with the spinal cord and brain. This biochemical change stimulates the body’s natural healing and regulating abilities to correct imbalances in temperature, hormone levels, and physical and emotional well-being. TCM acupuncture is a very safe and non-invasive therapy and research has suggested that of the myriad of symptoms menopause can present with, hot flashes and night sweating appear to respond quite quickly with just acupuncture.

One of the common approaches western medicine takes is hormone therapy, and though effective, hormone therapy may come with negative side effects such as breast and ovarian disorders, or individuals may have contraindications or are unwilling to use hormone therapy. TCM offers a natural and safe alternative often combining acupuncture with TCM herbal formulas as an adjunct to increase the efficacy of an acupuncture treatment. Herbal formulas are comprised of a balancing blend of ingredients found in nature. They often have little to no side effects, aside from allergies to a particular plant or plant part, and like homeopathy, TCM takes advantage of the therapeutic properties these plant materials offer to create formulas that address both symptoms and their underlying root causes. There is no one particular herbal formula to address symptoms of menopause as each herbal formula is unique in its ability to address underlying root causes of symptoms. After a consultation, your TCM practitioner will be able to prescribe an appropriate herbal formula to specifically address your condition.

The combination of TCM acupuncture, herbal formulas, and the addition of TCM dietary suggestions assists the body during this transition into menopause. Rather than the abrupt and drastic decline in hormones that the body is forced into during menopause, TCM takes a natural and whole-body approach to assist the body with a balanced and gradual change in hormone levels. However, regulating the body’s internal thermostat does work exactly like the thermostat on our wall, therefore patience and consistency is necessary to experience change.

TCM therapies can be used in conjunction with other forms of treatments including Western medicine, naturopathy, chiropractic, homeopathy, massage therapy, and so forth. When combing TCM acupuncture with other interventions (medication, supplements, herbal formulas, other therapies), studies have concluded that this combination is more effective than those interventions alone.

Sources:

Johnson A., Roberts L., Elkins G. Complementary and Alternative Medicine for Menopause. Journal of Evidence-Based Integrative Medicine. (2019). doi:10.1177/2515690X19829380

Lund KS., Siersma V., Brodersen J., et al. Efficacy of a standardized acupuncture approach for women with bothersome menopausal symptoms: a pragmatic randomized study in primary care (the ACOM study). (2019). 9:e023637. doi:10.1136/ bmjopen-2018-023637

Lian-Wei X., Man J., Roland S., et al. Hindawi Publishing Corporation Evidence-Based Complementary and Alternative Medicine. Review Article Efficacy and Side Effects of Chinese Herbal Medicine for Menopausal Symptoms: A Critical Review. (2012). Article ID 568106, 19 pages doi:10.1155/2012/568106

Kim KH., Kang KW., Kim DI., et al. Effects of acupuncture on hot flashes in perimenopausal and postmenopausal women-a multicenter randomized clinical trial. Menopause. (2010) Mar;17(2):269-80. doi: 10.1097/gme.0b013e3181bfac3b. PMID: 19907348.

*This blog is not intended to officially establish a physician-patient relationship, to replace the services of a trained physician, naturopathic doctor, physical therapist or chiropractor or otherwise to be a substitute for professional medical advice, diagnosis, or treatment.

Low energy?  You could be anemic.

Written by: Dr. Fiona Lovely, Chiropractor

Practitioner of Functional Neurology and Functional Medicine at AST

Many women complain of fatigue and low energy.  It has become a hallmark of modern lifestyle.  While there can be many reasons for fatigue, all of them worthy of investigation by your trusted health care provider, anemia is a common problem causing a woman to feel exhausted no matter how much rest she has had.  Anemia is a common cause of weakness, fatigue and shortness of breath.

Anemia is defined by a deficiency of red blood cells or haemoglobin in the blood.  These important elements carry oxygen to all the tissues of the brain and body.  There are different types of anemia but a common one for women in the perimenopausal years (35-55) is iron deficiency anemia.  This means that your red blood cells cannot carry a sufficient amount of oxygen to your brain and body leading to fatigue. 

If you know you have anemia, it’s important to know what type of anemia you have so that you may supplement your diet accordingly.  Your last lab tests will give the clues about what kind of anemia you are experiencing.  For example: you may have a deficiency of B12 or folate (vitamin B9) which can easily be supplemented with a high quality vitamin like we carry in our AST dispensary.  

Iron should be replenished by our diet.  Dark green leafy veggies, lentils, liver, red meat, and fish are good sources.  If you are eating a veggie-forward diet, please be sure to consume foods high in vitamin C with your meals to help with absorption of iron.  Cooking in a cast iron pan will also impart iron into the foods you consume.  

It helps to understand that a woman loses iron monthly with her menstrual bleed, so you must be replenishing this lost iron continuously.  If she has fibroids or endometriosis or short cycles or is bleeding heavily, then this loss of resources can be difficult to keep up with requiring an iron supplement daily.  There are many types of iron supplements, please speak to you practitioner to get the best one for you. 

Want to know more about how to feel better and have more energy?  Please tune into Episode 086 of the Not Your Mother’s Menopause podcast for tactical tools on how to correct anemia.

You can find Dr. Fiona Lovely working at AST Willow Park.